Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome
Hypothermic oxygenated machine perfusion (HOPE) has become an integral technique to enhance donor graft function in liver transplantation (LiTx). This study compares early posttransplant outcomes of mono-HOPE (portal vein perfusion only) versus dual- HOPE (both portal vein and hepatic artery perfusi...
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Frontiers Media S.A.
2025-02-01
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| Series: | Transplant International |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.13891/full |
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| author | Dominik Thomas Koch Dominik Thomas Koch Micol Tamai Malte Schirren Malte Schirren Moritz Drefs Moritz Drefs Severin Jacobi Severin Jacobi Christian M. Lange Christian M. Lange Matthias Ilmer Matthias Ilmer Matthias Ilmer Hanno Nieß Hanno Nieß Bernhard Renz Bernhard Renz Jens Werner Jens Werner Markus Guba Markus Guba Dionysios Koliogiannis Dionysios Koliogiannis |
| author_facet | Dominik Thomas Koch Dominik Thomas Koch Micol Tamai Malte Schirren Malte Schirren Moritz Drefs Moritz Drefs Severin Jacobi Severin Jacobi Christian M. Lange Christian M. Lange Matthias Ilmer Matthias Ilmer Matthias Ilmer Hanno Nieß Hanno Nieß Bernhard Renz Bernhard Renz Jens Werner Jens Werner Markus Guba Markus Guba Dionysios Koliogiannis Dionysios Koliogiannis |
| author_sort | Dominik Thomas Koch |
| collection | DOAJ |
| description | Hypothermic oxygenated machine perfusion (HOPE) has become an integral technique to enhance donor graft function in liver transplantation (LiTx). This study compares early posttransplant outcomes of mono-HOPE (portal vein perfusion only) versus dual- HOPE (both portal vein and hepatic artery perfusion). A retrospective analysis was conducted on 183 LiTx recipients, with 90 receiving mono-HOPE and 93 receiving dual-HOPE grafts. Propensity Score Matching (PSM) was applied, resulting in a matched cohort of 146 patients. Primary outcomes included one-year patient and graft survival, and non-anastomotic biliary strictures (NAS). Secondary outcomes included hospital length of stay (HLS). One-year patient survival was 81.7% in the mono-HOPE and 81.7% in the dual-HOPE group, and overall survival did not differ (p = 0.990). One-year death-censored graft survival was similarly comparable (91.2% vs. 93.3%, p = 0.893). NAS were observed in 10.96% in the mono-HOPE and 8.22% in the dual-HOPE group (p = 0.574). The median HLS was 29 days for both groups. Results suggest that dual-HOPE did not significantly improve patient or graft survival, nor did it reduce NAS or HLS compared to mono-HOPE. Assuming that larger cohorts and long-term follow-up data confirm this, additional cannulation of the hepatic artery during machine perfusion in hypothermic conditions may not be beneficial. |
| format | Article |
| id | doaj-art-ac21dc8115e4422599bbeed028dd1ac4 |
| institution | Kabale University |
| issn | 1432-2277 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Transplant International |
| spelling | doaj-art-ac21dc8115e4422599bbeed028dd1ac42025-02-05T04:11:22ZengFrontiers Media S.A.Transplant International1432-22772025-02-013810.3389/ti.2025.1389113891Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft OutcomeDominik Thomas Koch0Dominik Thomas Koch1Micol Tamai2Malte Schirren3Malte Schirren4Moritz Drefs5Moritz Drefs6Severin Jacobi7Severin Jacobi8Christian M. Lange9Christian M. Lange10Matthias Ilmer11Matthias Ilmer12Matthias Ilmer13Hanno Nieß14Hanno Nieß15Bernhard Renz16Bernhard Renz17Jens Werner18Jens Werner19Markus Guba20Markus Guba21Dionysios Koliogiannis22Dionysios Koliogiannis23Department of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Internal Medicine II, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDivision of General Surgery, Mayo Clinic, Rochester, MN, United StatesDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, GermanyTransplantation Center Munich, LMU University Hospital, LMU Munich, Munich, GermanyHypothermic oxygenated machine perfusion (HOPE) has become an integral technique to enhance donor graft function in liver transplantation (LiTx). This study compares early posttransplant outcomes of mono-HOPE (portal vein perfusion only) versus dual- HOPE (both portal vein and hepatic artery perfusion). A retrospective analysis was conducted on 183 LiTx recipients, with 90 receiving mono-HOPE and 93 receiving dual-HOPE grafts. Propensity Score Matching (PSM) was applied, resulting in a matched cohort of 146 patients. Primary outcomes included one-year patient and graft survival, and non-anastomotic biliary strictures (NAS). Secondary outcomes included hospital length of stay (HLS). One-year patient survival was 81.7% in the mono-HOPE and 81.7% in the dual-HOPE group, and overall survival did not differ (p = 0.990). One-year death-censored graft survival was similarly comparable (91.2% vs. 93.3%, p = 0.893). NAS were observed in 10.96% in the mono-HOPE and 8.22% in the dual-HOPE group (p = 0.574). The median HLS was 29 days for both groups. Results suggest that dual-HOPE did not significantly improve patient or graft survival, nor did it reduce NAS or HLS compared to mono-HOPE. Assuming that larger cohorts and long-term follow-up data confirm this, additional cannulation of the hepatic artery during machine perfusion in hypothermic conditions may not be beneficial.https://www.frontierspartnerships.org/articles/10.3389/ti.2025.13891/fullliver transplantationend-ischemic liver preservationhypothermic oxygenated machine perfusionmono-Hopedual-HOPE |
| spellingShingle | Dominik Thomas Koch Dominik Thomas Koch Micol Tamai Malte Schirren Malte Schirren Moritz Drefs Moritz Drefs Severin Jacobi Severin Jacobi Christian M. Lange Christian M. Lange Matthias Ilmer Matthias Ilmer Matthias Ilmer Hanno Nieß Hanno Nieß Bernhard Renz Bernhard Renz Jens Werner Jens Werner Markus Guba Markus Guba Dionysios Koliogiannis Dionysios Koliogiannis Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome Transplant International liver transplantation end-ischemic liver preservation hypothermic oxygenated machine perfusion mono-Hope dual-HOPE |
| title | Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome |
| title_full | Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome |
| title_fullStr | Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome |
| title_full_unstemmed | Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome |
| title_short | Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome |
| title_sort | mono hope versus dual hope in liver transplantation a propensity score matched evaluation of early graft outcome |
| topic | liver transplantation end-ischemic liver preservation hypothermic oxygenated machine perfusion mono-Hope dual-HOPE |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.13891/full |
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